Premium
Homocysteine, white matter hyperintensities, and cognition in healthy elderly people
Author(s) -
Dufouil Carole,
Alpérovitch Annick,
Ducros Véronique,
Tzourio Christophe
Publication year - 2003
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.10440
Subject(s) - homocysteine , hyperintensity , hyperhomocysteinemia , dementia , white matter , medicine , trail making test , psychology , cognitive decline , cognition , neuropsychological test , leukoaraiosis , cardiology , cognitive disorder , magnetic resonance imaging , neuropsychology , psychiatry , disease , radiology
Hyperhomocysteinemia is associated with an increased risk of vascular disease, and recent results suggest that it also could increase the risk of dementia. We examined the relationship between homocysteine and cognitive decline in 1,241 subjects aged 61 to 73 years, followed up over 4 years. Plasma homocysteine levels were determined in all participants as well as cardiovascular risk factors, apolipoprotein E genotype, plasma levels of folate, and vitamin B12. Cognitive performances were assessed repeatedly by using Mini‐Mental State Examination, Trail Making Test, Digit Symbol Substitution Test, and Finger Tapping Test. At 2‐year follow‐up, 841 subjects underwent cerebral magnetic resonance imaging, and white matter hyperintensities were rated visually. Analyses were adjusted for all cardiovascular risk factors. Cross‐sectional analyses showed that higher concentrations of homocysteine were significantly related to poorer performances at all neuropsychological tests. Longitudinal analyses confirmed this finding. The odds of cognitive decline was 2.8‐fold ( p < 0.05) higher in subjects with homocysteine levels above 15μmol/L compared with those with homocysteine levels below 10μmol/L. In participants who underwent magnetic resonance imaging, the relationship between homocysteine and cognition was unchanged after taking into account white matter hyperintensities suggesting that white matter hyperintensities do not mediate the association between homocysteine and cognition. Ann Neurol 2003;53:000–000